All issues > Volume 24(2); 1981

Original Article

J Korean Pediatr Soc. 1981;24(2):136-144. Published online February 15, 1981.

A Clinical Study of 15 Cases of Pneumocystis Carinii Pneumonia.

Jae Oh Kim¹, Sung Sook Cho¹, Jung Woo Suk¹, Don Hee Ahn¹, Keun Chan Sohn¹, Tai Hyuk Yim²

¹Department of Pediatrics, National Medical Center Seoul, Korea.
²Department of Pediatrics, St. Colomban hospital, Choon cheon, Korea.

Abstract

Pneumocystis carinii pneumonia is unique infection with unyielding penchant for the debilitated and immunodeficient host. Since several reports of pneumocystis carinii pneumonia in late half of 1950 period, no additional report was found in literature in Korea. We Tecently experienced 15 cases of pneumocystis carinii pneumonia in infants of an institution for foreign adoption, who, were admitted to our*hospital with the chief complaints of dyspnea and cyanosis in two epidemic periods of Feb. 1979 and Marchj 1980. The clinical review was made.1.Epidemiology: The 1st & 2nd attack rate among infants of institution were 6.1%, 4.1% respectively with higher incidence in premature infants. Patients’ age was almostlybetween2 to 3 months. Many patients were included in low birth weight with poor weight gaining and development. Duration between entrance to the institution and the development of the disease was around 50-60 days. Fatality rate was 33.3%. 2.Presented common symptoms were tachypnea (100%), cyanosis(86.7%), restlessness(66.7%), hacking cough(60.0%) in order of frequency.Respiration rate was over 70/min. in many cases.3.Gas analysis showed low pO2 and O2 saturation. Hematologic and other lab. findings were all within normal limits.4.Chest Xray showed common generalized granular patterns, which were originated at hilus and extended peripherally. Interstitial density was more common than alveolar density.5.Open lung biopsy showed highest positive rate for confirmative diagnosis.6.The effects of trimethoprim-sulfamethoxazole showed good results when started within 1 week after the:onset of symptoms.7.In 5 cases of autopsy, histopathologic findings of all cases were confined to lung and many cysts of pneumocystis carinii were noted in alveolar spaces and interstitium with thickened alveolar septum by Gomeri methenamine silver nitrate stain.

Keywords :Pneumocystis;Pneumonia;infants in institution